As I look back at the JEMS.com columns I wrote in 2010, there seems to have been a good balance of topics and tone. I honestly don’t know what I will write about when I sit down at my Mac to compose these pieces. But something always comes out. I actually like the spontaneity and lack of organization in this regard (although it drives Lauren, my editor, crazy). I realize that I will occasionally write a dark piece—primarily to stimulate thought. But I do enjoy this part of my life—writing what’s on my mind. The good thing about these web-based columns is that the reader can immediately react to the article and e-mail me their thoughts (or post a comment below the piece). Such feedback isn’t so easy in traditional printed media.

Ride Along
I wasn’t sure what I would write for this holiday month. As usual, however, something came to mind. A few weeks ago, I rode two days in a row with EMS crews in Las Vegas. The first day was with an all-female crew and the second was an all-male crew. As luck would have it, both shifts were painfully slow. The first night we sat for hours in the parking lot of a Wendy’s, and the next day we sat in the warm sun outside Starbucks. Much to my surprise (and pleasure), both crews wanted to talk about the future of EMS. In my EMS days, if I had my medical director captive in the back of my ambulance, I’d complain about everything possible. That was not the case with the MedicWest crews with whom I rode.

The two females, a paramedic and an EMT-Intermediate, were experienced EMS providers and could hold their own against any group of men. Both were deeply involved in EMS and loved the work. One had two bachelor’s degrees but decided against attending medical school because of her love for EMS. The other was also seeking additional education. However, when I questioned them about why they were taking additional educational offerings, both said they wanted to use their education and experience to help improve EMS. Both also said they could never “leave the streets.” We talked for hours about what was wrong and what was right with EMS. It was a pleasant evening.

The next day I randomly flagged down a MedicWest crew at University Medical Center. I grabbed my camera and jacket and hopped in the back of the ambulance. We drove around, ran a nonsense call, and then we stopped at Starbucks. Again, as with the crew the day before, the conversation turned to the state of EMS and the future of this noble profession. Both paramedics were seeking additional education.

Both had their undergraduate degrees. One was preparing to enter law school at the University of Nevada Las Vegas (UNLV), and the other was looking at becoming a physician assistant or attending medical school. But both vowed to use their education to improve EMS. They asked me hard questions—not about the ambulance service—but about the profession. We had candid, detailed and open discussion about what we felt was right and what we felt was wrong. Between the four MedicWest crewmembers, I saw a passion and love for EMS that I haven’t seen in a while. Jim Page would have smiled had he been there with me.

Perhaps I spend too much time in conferences or the halls of the hospital and not with the rank and file of EMS. I actually was a little sad when the dispatcher released the crew to go home and take me back to the hospital to pick up my car. I wanted to hear more of what they had to say. The most interesting thing about these two days is that these four EMS professionals have maintained their passion and professionalism despite hard times.

Las Vegas is much more than the lights of the strip and the constant noise of slot machines. The unemployment rate in Las Vegas is nearly 15%—the highest in the country. When the economy turns south, people don’t gamble, and Vegas is a gambler’s town. Las Vegas hosts a large homeless community, and substance abuse is among the worst in the nation. On top of that, there’s the ever-present fire versus private EMS discourse. Fortunately, on scene, fire and EMS work wonderfully together with mutual respect and cooperation.

That said, Vegas is a tough EMS town. Despite this toughness, the four EMS professionals I spent the day with renewed my hope that a better day awaits EMTs and paramedics. Those of us older EMS types can rest assured that there are many who will carry on the charge and work, tirelessly, to make EMS better for the patient and the provider. I can’t wait to ride out again.

As I have done the last few years, here is a link to one of my favorite Christmas songs. It’s special to me because I used to play this song on the radio (in a part of my life before EMS and medicine) and also got to meet Jim Croce not long before he died. Enjoy!

Bryan Bledsoe, DO, FACEP, FAAEM, EMT-PDr. Bledsoe is an emergency physician and Professor of Emergency Medicine and Director of the EMS fellowship at the University of Nevada School of Medicine in Las Vegas. He is the author of numerous EMS textbooks and articles.